Tests and Diagnosis

The Emory Epilepsy Center offers comprehensive epilepsy diagnosis, treatment, and rehabilitation services. The Center uses the latest diagnostic tools to identify the causes of epilepsy. These tools include:

  • Routine EEG (Electroencephalography) to record the electrical activity of the brain. EEGs are performed to determine whether abnormal brainwaves are present, which can aid in the diagnosis of seizures, as well as other neurologic disorders.
  • Ambulatory EEG to measure the electrical activity of the brain over a 48-hour period. The patient wears EEG electrodes at home for 2-3 days, which allows for the capture of the patient’s typical spells/seizures to aid in diagnosis.
  • Inpatient Video EEG to measure the electrical activity of the brain while patients are hospitalized for 3-5 days in Emory’s Epilepsy Monitoring Unit (EMU). During hospitalization in the EMU, EEG is recorded 24 hours a day, along with concurrent video. Antiseizure medications are lowered during hospitalization in an attempt to capture and characterize seizures and spells, for diagnostic purposes or presurgical planning.
  • Structural Neuroimaging, a major diagnostic service of the Emory Epilepsy Center and Emory Department of Radiology, to detect lesions and biochemical dysfunction that cause epilepsy.
  • Functional Imaging with positron emission tomography (PET) or single photon emission computed tomography (SPECT) scans, as well as functional MRI (fMRI) scans, to map the patterns of blood flow, energy use and membrane receptors in specific brain regions.
  • Neuropsychological Testing to measure the severity of memory and other cognitive dysfunction that can occur in many individuals with epilepsy.
  • Genetic Testing, Blood Chemistry and other Laboratory Tests also can help identify the causes of epilepsy.

For many patients, epileptic seizures and non-epileptic seizures cause the same types of feelings, movements and other behaviors, but EEG recordings can distinguish epileptic from non-epileptic seizures.

In order to more accurately diagnose epilepsy and seizures, these recordings are usually performed in an Epilepsy Monitoring Unit (EMU), a 10-bed inpatient unit at Emory University Hospital, with continuous digital video recording. Patients are admitted for continuous Video-EEG monitoring, while data is recorded 24 hours a day, along with time-locked video. Antiseizure medications are reduced, allowing for the capture and characterization of the patient’s typical spells. Often times, patients have been misdiagnosed with seizures, and as a result of Video-EEG monitoring, antiseizure medications can be discontinued. Additionally, accurate diagnosis can lead to selection of the most effective medication for the captured seizure type.

Many patients have a combination of epileptic seizures and non-epileptic seizures. Video-EEG monitoring can be used to show which seizures should be treated with epilepsy medications and which seizures are non-epileptic and require a different form of treatment. A high degree of expertise, which can be found with the Emory Epilepsy Center staff, is necessary to interpret Video-EEG recordings correctly. Video-EEG monitoring can also be performed as part of the pre-surgical workup in patients with epilepsy whose seizures do not respond to antiepileptic medication. With Video-EEG, epilepsy doctors aim to find the area of the brain where seizures are starting. This helps determine whether surgery is a treatment option.

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